Some documentation which must be maintained to support the reimbursement of SBAP services are educational in nature, such as the IEP or IFSP. For questions and guidance on those educational documents, please refer to the Pennsylvania Department of Education.
- Medical Practitioner Authorization Form (MPAF) with instructions — Effective Oct. 1, 2024
- Medical Practitioner Authorization Form (MPAF) (Form Only) — Effective Oct. 1, 2024
- Audiology Service Provider Log
- Hearing-Impaired Service Provider Log
- Nursing Service Provider Log
- Occupational Therapy Service Provider Log
- Orientation, Mobility & Vision Service Provider Log
- Personal Care Service Provider Log
- Physical Therapy Service Provider Log
- Physician Service Provider Log
- Psychiatric Service Provider Log
- Psychological Service Provider Log
- Service Provider Evaluation Log
- Social Work & Counseling Service Provider Log
- Special Transportation Services Provider Log
- Speech and Language Service Provider Log
By signing the Parental Consent form, the parent or guardian is granting permission for the LEA to access their public insurance (MA) and share with the State Medicaid Agency the information necessary to bill the MA Program for services delivered to their child.
While the parent/guardian does not need to sign a new parental consent each year, the LEA is required to provide an annual notification to serve as a reminder that they previously granted that access.
PA Annual Notice of Parental Consent for Medical Assistance Billing:
- Claiming for Assistive Devices Form
- Wiew the training session or slides from the training